Term
| When inspecting an uncircumsized penis, it is important to... |
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Definition
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Term
| When examining the urethral meatus of the penis by gentle separation, it should be _____. |
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Definition
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Term
| __________ from or bright _____ appearance (erythema) of the urethral meatus may indicate the presence of inflammatory/infectious disease. |
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Definition
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Term
| Which testicle usually lies lower in the scrotum? |
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Definition
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Term
| The surface of the scrotum is usually somewhat coarse and _______ and may have small nodularities called __________ _______. |
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Definition
| rugated; epidermoid cysts |
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Term
| Testes are generally ____, _____, and ____. |
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Definition
| soft, smooth, and rubbery |
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Term
| How do you check for a hernia? |
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Definition
| Utilizing one finger, gently follow the vas deferens from the scrotum to the external ring and ask the patient to valsalva or cough. |
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Term
| While checking for a hernia, note any lesions felt from the ______ _____ or around it and visually note any lesions in the _______ or ______ area. |
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Definition
| external ring; inguinal or femoral area |
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Term
| A direct inguinal hernia goes through _______ _______ which is ______ to your finger during the exam. |
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Definition
| Hasselbach's triangle; lateral |
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Term
| An indirect hernia goes through the ____ _____ _____ to the _______ _____ _____ which _____ ______ your finger during the exam. |
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Definition
| deep inguinal ring; superficial inguinal ring; pushes against |
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Term
| A femoral hernia occurs below the ______ _______. |
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Definition
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Term
| borders of Hasselbach's triangle |
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Definition
lateral--inguinal canal
medial--rectus abdominus muscle
superior--vessels |
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Term
| The inguinal canal runs from the ____ _____ to the _____ ______. |
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Definition
| iliac crest; pubic tubercle |
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Term
| What does it mean if a hernia is reducible? |
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Definition
you are able to push the intestine back in
good prognosis because blood supply is not in jeopardy |
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Term
| What does it mean if a hernia is incarcerated? |
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Definition
you can't reduce it
bad prognosis because blood supply may be in jeopardy |
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Term
| What does it mean if a hernia is strangulated? |
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Definition
blood supply has been cut off
immediate surgery needed |
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Term
| Which type of hernia is more common in women? |
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Definition
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Term
| Which type of hernia is common in children? |
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Definition
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Term
| What is a communicating hydrocele? |
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Definition
| communicates with the abdominal cavity; congenital |
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Term
| What is a noncommunicating hydrocele? |
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Definition
| does not communicate with the abdominal cavity; occurs in men over the age of 40 |
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Term
| What is the clinical manifestation of a hydrocele? |
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Definition
painless, enlarged scrotum
no other GU symptoms |
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Term
| How do you identify a hydrocele in your physical exam? |
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Definition
superior and anterior to testicle
will transilluminate
usually unilateral |
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Term
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Definition
| benign cystic mass in the epididymus |
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Term
| How common are spermatoceles? |
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Definition
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Term
| What is the clinical manifestation of a spermatocele? |
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Definition
usually painless
incidental finding |
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Term
| How do you identify a spermatocele in your physical exam? |
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Definition
discrete cystic mass less than 1 cm
valsalva negative
will not transilluminate |
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Term
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Definition
| dilation of the pampiniform plexus |
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Term
| Which side is more common to have a varicocele? |
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Definition
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Term
| Varicoceles occur in __-__% of normal men and __% of infertile men. |
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Definition
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Term
| Varicoceles are usually __________. |
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Definition
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Term
| How do you identify a varicocele in your physical exam? |
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Definition
fullness, usually in spermatic cord
"bad of worms" |
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Term
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Definition
| acute inflammatory reaction of the testis secondary to infection |
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Term
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Definition
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Term
| What are the clinical manifestations of orchitis? |
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Definition
variable
symptoms of infection
history of antecedent infection
nausea |
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Term
| How do you identify orchitis on your physical exam? |
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Definition
swelling
pain to palpation
scrotal erythema
epididymitis
possible penile discharge
possible parotitis |
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Term
| What disease should you think of if a patient has orchitis? |
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Definition
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Term
| What should you be concerned about if a patient has a right sided varicocele? |
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Definition
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Term
| What is the etiology of a testicular torsion? |
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Definition
twisting of the spermatic cord 180-720 degrees
left more common than right
bell clapper deformity |
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Term
| What is the incidence of testicular torsions? |
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Definition
peak at 13 years old
16% of ER visits with acute scrotal pain |
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Term
| What are the clinical manifestations of a testicular torsion? |
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Definition
severe pain
nausea and vomiting
red, swollen, and tender scrotum |
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Term
| How do you identify a testicular torsion in your physical exam? |
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Definition
| painful non-transilluminating mass |
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Term
| What are the 2 possible causes of epididymitis? |
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Definition
reflux of infectious material from urethra
hematogenous infection that spreads |
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Term
| What are the clinical manifestations of epdidymitis? |
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Definition
insidious onset
antecedent infection |
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Term
| How do you identify epididymitis on your physical exam? |
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Definition
pain
swollen epididymis
positive Prehn's sign
2nd degree orchitis |
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Term
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Definition
| elevate scrotum and pain is relieved |
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Term
| What is the treatment for epididymitis? |
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Definition
| antibiotic, elevation, ice |
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Term
| What condition should you think of if a patient under the age of 35 comes in with epididymitis? |
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Definition
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Term
| What condition should you think of if an older patient comes in with epididymitis? |
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Definition
| intestinal bacteria--E. coli |
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Term
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Definition
sustained erection that can cut off blood supply
medical emergency--stick a needle in to decompress it |
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Term
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Definition
inflammation of the glans that occurs most commonly in uncircumsized patients
can get yeast infections
If glans swells and foreskin doesn't, blood supply to the glans can get cut off. |
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Term
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Definition
| inability to retract the foreskin (only in uncircumsized patients) due to adhesions between the foreskin and the glans |
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Term
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Definition
medical emergency
can retract foreskin but then it won't go back over glans
causes cut off of blood supply to glans
can be caused by a catheter |
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Term
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Definition
| congenital, ventral displacement of the urethral meatus on the penis |
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Term
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Definition
| congential abnormality in which the urethra meatus exits the penis on the dorsal surface |
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Term
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Definition
undescended testes
if not descended by age 1, surgery is needed |
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Term
| What is a sign of internal hemorrhoids? |
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Definition
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Term
| External hemorrhoids can be ______ or _______. |
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Definition
| reducible or incarcerated |
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Term
| Superficial anal fissures can occur as a result of __________. |
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Definition
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Term
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Definition
| passageway from one hollow organ to another that should not be there |
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Term
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Definition
| infection of the rectal gland that secretes mucus |
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Term
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Definition
| infection of soft tissue around anus |
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Term
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Definition
occur in men under the age of 30-40
full of oil and debris
hair may irritate it
treatment: drain and pack; if too large, excise the entire area |
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Term
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Definition
part of rectum falls out of anus
sensitive mucosa is irritated by underwear |
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Term
| What zones of the prostate enlarge as a man ages causing difficulty urinating? |
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Definition
| transition and central zones |
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Term
| Which zone of the prostate is the most common area for cancer to develop in? |
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Definition
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Term
| How should the patient be positioned for the male rectal exam? |
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Definition
| either in Sims position (left lateral with right knee flexed) or standing bent over exam table |
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Term
| Dimpling in the sacrococcygeal and perianal area can indicate... |
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Definition
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Term
| Posterior wall of the prostate should be ____, ______, and slightly _______. |
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Definition
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